Past papers 2 Flashcards
If have gout in knee, poisoning with what leads to it
Lead
Which enzyme is the rate limiting step in de novo purine synthesis?
PAT
Which anticoagulant would you use in a patient with DVT and renal failure?
Warfarin
Name the first line treatment for Wilson’s Disease.
Zinc
What might cause a mildly elevated ALT?
Fatty liver
Which protein is defective in Polycystic Kidney Disease?
Polycystein-1
Which cause of nephrotic syndrome doesn’t respond to high dose steroids?
Membranous
Which cytokine is predominantly responsible for T cell proliferation and survival?
IL-2
What infection associated with mixed cryoglobulinaemia
Hep C
What is evans syndrome
Type II HS seen mainly in CLL
AIHA and ITP
Difference between NF1 and NF2
NF 1- astrocytomas, neurofibromas and optic gliomas
NF2 - vestibular schwannomas, meningiomas, ependymomas and astrocytomas
Which syndrome presents with parkinsonism, dystonia, apraxia and ‘alien limbs’ phenomenon?
Corticobasal
Which Parkinson Plus Syndrome presents with early autonomic dysfunction?
Multiple system atrophy
Which Parkinson Plus syndrome is associated with early falls, axial rigidity, akinesia, dysarthria and dysphagia?
Progressive supranuclear palsy
Which tumour is ventricular, and associated with hydrocephalus?
Ependyoma
Which brain tumour is soft, gelatinous and calcified?
Oligodendroma
Which bacteria is caught through reheated meats, causes diarrhoea and cramps and may cause gas gangrene?
Clostridium perfringens
Which lysosomal disorder occurs due to a defect in Hexoaminidase A, and leads to lipid accumulation, nervous damage and death at a young age?
Tay-sachs
Which group of disorders cause hypoglycaemia, lactic acidosis, hepatomegaly and developmental delay?
Glycogen storage
Name two examples of aminoacidopathies, which present with mental retardation, blue eyes and fair hair/skin
PKU
Maple syrup disease
How does the mannose binding pathway work?
MBL binds to microbial cell surface carbohydrates, which stimulates C2/4 of the classical pathway
Which pathways do CH50 and AP50 reflect
CH50- common pathway
AP50- alternative pathway
What do you do to assess allergies if a patient cannot stop anti-histamines or has a history of anaphylaxis?
RAST
Which cells may have potential to be utilised as cancer vaccines?
Dendritic
For which disease might you use Interferon Beta?
Behcets
Give an example of a passive vaccination
Varicella Zoster Ig
v
Help neutrophils
Which immunohisto stain targets epithelial cells?
Cytokeratin
Which leukaemia most commonly causes pancytopaenias?
Hairy cell
Main complication of hereditary elliptocytosis
Hydrops fetalis
In which condition are target cells commonly seen?
SCD
What do you do if a patient on warfarin presents with an INR of 6?
Withhold doses until below 5
An immunocompromised patient presents with disseminated TB. What is the most likely diagnosis?
Mycobacterium Avium
A man from Australia presents with painless nodules which are beginning to ulcer, scar and contract. What is the most likely diagnosis?
Mycobacterium ulcerans
Name a gram negative cocci that can cause typical Pneumonia
Moraxella cattarrhalis
What are the gram negative cocci
Neisseria species
Moraxalla species
What can cause painful inguinal buboes and genital elephantosis?
LGV
How do renal tubular acidosis type 1 and 2 cause acidosis
T1- Can’t excrete H+
T2- can’t reabsorb bicarb
When is Urobilinogen raised
Pre-hepatic
Which porphyria presents with urine colour change (Port Wine) with abdominal pain?
Acute intermittent porphyria
Which Thyroid Disease might display ‘Hurthle Cells’?
Hashimotos
What is the most common radiolucent cause of nephrolithiasis?
Uric acid
What does Hyxroxycarbimide do?
Increase foetal Hb
In which scenario is transfusion a better treatment for iron deficiency than oral iron?
Sepsis and severe infection as oral iron won’t absorb well
Management of sideroblastic anaemia
Pyridoxine
What would you see on iron studies of a pregnant lady?
Pregnancy
in which condition might you see a classical ‘hairs on end’ skull X-Ray?
Beta thalassaemia
How do you diagnose Paroxysmal Nocturnal haemoglobulinuria?
Hams test
When is Vitamin K indicated?
INR over 5 and bleeding
INR over 8 and not bleeding
Which T Cell lymphoma is most aggressive?
Anaplastic
Which agent can be used in the management of T Cell Lymphomas
Alemtuzumab
What does BCG stand for?
Bacille-calmette-guerin
Name a gram negative rod that causes typical pneumonia
Klebsiella
How is syphylis investigated?
Dark ground microscopy
What might cause a urea 10x higher than usual?
Upper GI bleed
Which HLA is associated with Haemochromatosis?
A3
What is serum sickness?
Type III HS to proteins in penicillin
Which hypersensitivity type is Chronic urticaria?
Type 2
What is Lynch Syndrome/HNPCC?
Carcinomas in right colon, associated with gynae cancers
Pancreatic cancer positive for lipase, trypsin and chymotrypsin
Acinar cell
Which stain is used for Alpha-1-antitrypsin deficiency?
Periodic acid schiff
In which condition might you see ‘wire-loop capillaries’ and ‘lumpy bumpy granular deposition in the GBM’ on a renal biopsy?
Lupus nephritis
Which breast cancer is associated with BRCA?
Basal like carcinoma
Which IL-6 Inhibitor can be used in hypoxic COVID?
Toclizumab
What is zanamivir used for?
Hep A and Flu in lung disease
What enzymes raised in sarcoid
ACE
Alpha 1 hydroxylase
What causes osteomyelitis in children?
Haem influenza
Group B strep
In which condition are ‘Brown Tumours’ seen?
Primary hyperparathyroid
A woman is prescribed a statin. What would be the expected effect on:
a) LDLs
b) HDLs
c) Triglycerides
LDL- reduction
HDL- increase
Triglycerides- slight increase
A lady presents with osteomalacia secondary to Vitamin D deficiency. Her medical history is remarkable for one, long term, well controlled condition. Which class of drugs are most likely to have contributed to her deficiency?
Anticonvulsants
A patient is found to be in a hyperglycaemic hyperosmolar state. Why must you take care in giving lots of fluids to this patient?
Cerebral oedema
If a red blood cell is described as ‘polychromatic’ on blood film, what does this mean.
Bluish appearance due to taking up eosinophilic and basophilic dyes. Occurs due to the presence of reticulocytes.
Which cancers are associated with secondary polycythaemias, and why?
Liver
Renal Cell
Ectopic EPO production
A patient presents with a rash and coryzal symptoms. They are found to have a basophilia on blood film. Which class of virus are they most likely to be infected with?
Poxvirus
A patient presents with a rash and coryzal symptoms. They are found to have a basophilia on blood film. Which class of virus are they most likely to be infected with?
Small cell lymphocytic
A lymphoma is shown to be positive for CD15 and CD30. Which histological subtype is it most likely to be?
Classical hodgkins lymphoma
A patient presents with a progressive dry cough. His medical history is notable for treated Hodgkin’s Lymphoma. What is the most likely diagnosis?
Pulmonary fibrosis
What is staginf for CLL
Rai and binet
What is mutation in reticular dysgenesis
Adenylate kinase 2
How would you test function of the alternative complement pathway?
AP50
A patient undergoing chemotherapy presents with recurrent infections and low neutrophil counts. They never experienced similar issues before starting chemotherapy. What is the most likely diagnosis?
Mannose binding leptin
A patient is found to be anaemic, and has lots of variation in the size and shape of erythrocytes on blood film. What is this sign called, and what is the likely cause of their anaemia?
Anisopoikilocytosis
Iron Deficiency Anaemia
An infant is found to have very low T Cells, very low B Cells and very low NK Cells?
Adenosine deaminase
A man presents with non-bloody loose stools. He does not have a fever. He recently ate some chicken. Culture grows Gram Negative Rods. What is the likely causative organism?
Salmonella enteritidis
Which enteric bacterium has the lowest infective dose?
Shigella
A patient presents with descending paralysis. he reports visiting a farm recently and trying their honey. What is the most likely causative organism?
Clostridium botulinum
Treatment for entamoeba histolytica
Metronidazole
What type of drug is lopinavir?
Protease inhibitor
What is the most common cause of hospital-acquired pneumonia?
Enterobacteriaciae (E.Coli, Klebsiella)
A patient presents with a chronic productive cough. Biopsy shows dilatation of the airways, goblet cell hyperplasia and hypertrophy of mucous glands. What is the most likely diagnosis?
Chronic bronchitis
A child presents with episodes of cough and wheeze, with associated dyspnoea. They have a history of eczema. Histology shows whorls of shed epithelium, eosinophils and Charcot-Leyden Crystals. What is the most likely diagnosis?
Asthma
A patient presents with dyspnoea and cough. Histology shows loss of the alveolar parenchyma distal to the terminal bronchiole. What is the most likely diagnosis?
Emphysema
What is the most common cause of a non-anaemic macrocytosis?
Alcohol
What is the most common oestrogen-secreting tumour?
Mucinous cystadenoma
What is the most common malignancy in Equatorial Africa?
Burkitts lymphoma
What is the most common cause of Cerebral Infarction?
Cerebral atherosclerosis
What is the most common cause of Nephrotic Syndrome in Afro-Caribbean people?
FSGS
Most common benign tumour of the bone
Osteochondroma
What is the most common Neuroepithelial Tumour?
Astrocytoma
What is the most common location for an undescended testis?
Inguinal canal
What is the treatment for aspiration pneumonia?
Tazocin and metronidazole
What is the second line management for Minimal Change Disease?
Ciclosporin
How is Salmonella treated?
Ceftriazone
How is Campylobacter treated?
Erythomycin/ciprofloxacin
How would you manage someone with Vitamin K Deficiency who is acutely haemorrhaging?
FFP
How might Myasthenia Gravis be treated?
Neostigmine
How is Burkitt’s Lymphoma treated?
Rituximab
How is Haemochromatosis treated?
Desferrioxamine
Venesection
How to differentiate between TRALI and TACO
TRALI has hypotension
Patient with thymoma and proximal muscle weakness
Myasthenia gravis
Neutropenic sepsis most common cause
Staph epidermis- coagulase negative
What is fastest growing known tumour
Burkitts lymphoma
Which bone tumour metastasises rapidly to the lungs
Osteosarcoma
What do ewings sarcoma vs osteosarcomas form
Osteosarcomas- bone
Ewings sarcoma- mesenchymal tissue
Which inherited disorder of metabolism can lead to recurrent E coli infections
Galactossaemia
Which infection does C3 infection predominantly predispose to
N meningitidis
What is CSF finding of neurosyphyllis
High lymphocytes
High protein
What does Alk-1 mean in anaplastic lymphoma
Good prognosis
